Methods and Apparatus for Coupling an Optical Input to an Illumination Device

ABSTRACT

A surgical illumination apparatus comprises a fiber optic input, and illuminated surgical instrument, and an optical coupling bracket for coupling the fiber optic input to the illuminated surgical instrument. The coupling bracket comprises an elongate frame having a proximal end, a distal end, and a central channel extending therebetween, wherein the central channel is sized to receive and support optical fibers of the fiber optic input. The proximal end of the bracket is coupled to the fiber optic input, and the distal end of the bracket is coupled to an illumination element of the illuminated surgical instrument. The apparatus may further comprise a shroud disposed around the illumination element that is coupled to the bracket.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. patent applicationSer. No. 16/601,164, filed Oct. 14, 2019, which is a continuation ofU.S. patent application Ser. No. 16/376,681, filed Apr. 5, 2019 (issuedas U.S. Pat. No. 10,512,520 on Dec. 24, 2019), which is a divisional ofU.S. patent application Ser. No. 14/957,452, filed Dec. 2, 2015 (issuedas U.S. Pat. No. 10,321,969 on Jun. 18, 2019), which claims the benefitof U.S. Provisional Patent Application No. 62/086,653 filed on Dec. 2,2014; the entire contents of which are incorporated herein by reference.

This application is related to the following co-pending U.S. patentapplication Ser. Nos. 11/923,483; 14/035,583; 14/264,406; the entirecontents of which are incorporated herein by reference.

BACKGROUND OF THE INVENTION

The devices, systems and methods described below relate generally toilluminated devices such as medical devices, systems, and methods andpreferably relate to illumination of a surgical field, although this isnot intended to be limiting and usage outside of a surgical field isalso contemplated.

Illumination of target areas to allow an operator to clearly observe thetarget area can be challenging. External lighting provided by headlampsor wall mounted lights require constant adjustment and can still castunwanted shadows in the target area. These devices may be heavy and canbe uncomfortable to wear. Additionally, these illumination techniquesmay not be capable of illuminating a target area that is deep anddisposed far below a surface such as a surgical field in a patient.Other illumination techniques may use an illumination element such as afiber optic bundle which can be coupled to tools or other instrumentsand which are inserted into the target area thereby providing morelocalized illumination. Examples of this approach include surgicalretractor blades with fiber optics or other illumination elementscoupled thereto. Fiber optics can help illuminate the target area, butfiber optic systems can also be inefficient at transmitting light, andthe resulting light loss significantly reduces the amount of lightdelivered to the target area. Powerful light sources may be provided inan attempt to overcome the inefficiency of light transmission, but suchattempts can result in excessive heat generation, potentially leading tofires or thermal damage to the patient or surgical instruments beingused.

In addition to the challenges associated with the techniques describedabove, illuminated tools and instruments must not only provide adequateillumination of the work area, but they preferably must also be able toaccess tight spaces without occupying significant volume that otherwiseis needed for other tools and instruments, or an operator's hands, aswell as still allowing the operator an unobstructed view of the workingarea. With the introduction of newer minimally invasive surgicaltechniques, it has become especially important to provide illuminationsystems with low profiles, so that the systems may be used inconjunction with minimal surgical incisions.

In order to keep the profile of an illumination system as minimal aspossible, the optical coupling between the illumination input (e.g. afiber optic input cable or other input) and the illumination element(e.g. a fiber optic or an optical waveguide) is preferably in alow-profile configuration. Furthermore, it would be desirable for such alow-profile optical coupling to have robust structural support, both tosecure the attachment of the optical input to the illumination element,as well as protecting the coupling between the optical input andillumination element from excessive flexural loads and stresses thatcould disrupt the light input. It would also be desirable to provide anoptimized coupling between the optical input and the illuminationelement that is optically efficient to minimize light loss and resultinglocalized heating. In manufacturing such a low-profile illuminationsystem, it would also be desirable to provide a structure and method forfacilitating the handling of the optical input (e.g. fiber optic inputcable) during manufacturing and assembly processes. At least some ofthese objectives will be met by the exemplary embodiments describedherein.

SUMMARY OF THE INVENTION

Aspects of the present disclosure provide an apparatus and method forcoupling an optical input to an illumination element that is preferablycoupled to a surgical instrument in a low-profile configuration.

In a first aspect of the present disclosure, a surgical illuminationapparatus for illuminating a surgical field in a patient comprises afiber optic input, an illuminated surgical instrument, and an opticalcoupling bracket for coupling the fiber optic input to the illuminatedsurgical instrument. The illuminated surgical instrument comprises asurgical device and an illumination element coupled thereto, wherein theillumination element is coupled with the fiber optic input andconfigured to emit light from the fiber optic input toward the surgicalfield. The optical coupling bracket comprises an elongate frame having aproximal end, a distal end, and a central channel extendingtherebetween. The central channel is defined by an upper surface, alower surface, and two side walls, and is sized to receive and supportthe optical fibers of the fiber optic input. The distal end of theoptical coupling bracket is coupled to the illumination element.

The bracket may comprise one or more protruding members configured toengage the fiber optic input. The protruding members may be disposed onthe proximal end of the frame, adjacent both side walls of the centralchannel, extending in a direction transverse to the longitudinal axis ofthe frame.

The bracket may further comprise one or more engagement elementsconfigured to engage the illumination element. The engagement elementsmay be disposed on the distal end of the frame, and may comprise one ormore holes configured to capture pins, screws, or protrusions disposedon the proximal end of the illumination element.

One of the bracket or the illumination element may further comprise aprotrusion, and the other of the bracket or the illumination element maycomprise a receptacle. The protrusion may be configured to snap fit intothe receptacle to couple the bracket to the illumination element.

The one or more optical fibers of the fiber optic input may be capturedby the central channel of the bracket to couple the fiber optic input tothe bracket. The optical fibers may be arranged in one or more lineararrays that are vertically stacked atop one another, so as to have alow-profile configuration. An adhesive may be disposed in the centralchannel to fixedly couple the optical fibers to the frame.

The illumination element may comprise an optical waveguide, configuredto transmit light from the fiber optic input to the surgical field,directing the light to the surgical field through light-emittingsurfaces having surface features configured to extract and direct thelight. The optical waveguide may comprise a pocket disposed on theproximal end, where the pocket may be configured to receive the fiberoptic input. The optical waveguide may further comprise a pocketdisposed on the proximal end, where the pocket may be configured toreceive at least the distal end of the coupling bracket.

One of the optical waveguide or the surgical instrument may furthercomprise a protrusion and the other of the waveguide or the surgicalinstrument may comprise a matching receptacle. The protrusion may beconfigured to slide into the receptacle to couple the waveguide to theinstrument. The protrusion may have a dovetail shape and the matchingreceptacle may be a dovetail-shaped groove.

The surgical illumination apparatus may further comprise a shroudcoupled to an optical waveguide, wherein the shroud is disposed aroundat least a portion of the perimeter of the optical waveguide. The shroudmay have one or more openings on a top surface, a bottom surface, or onboth the top and the bottom surfaces, through which the light-emittingsurfaces of the optical waveguide can transmit light to the surgicalfield. The shroud may be configured to maintain an air gap between theshroud and the waveguide, so as to minimize interference with lightpropagation within the waveguide (e.g. due to light loss). The shroudmay further comprise one or more magnets integrated with the shroud,wherein the magnets may be configured to magnetically couple the shroudwith the surgical device.

The surgical illumination apparatus may further comprise a collardisposed over the coupling bracket, at least a portion of the fiberoptic input, and at least a portion of the illumination element. One ofthe collar or the coupling bracket may comprise a protrusion, and theother of the collar or the coupling bracket may comprise a receptacle.The protrusion may be configured to snap fit into the receptacle tocouple the collar to the coupling bracket. One of the collar or theillumination element may comprise a protrusion, and the other of thecollar or the illumination element may comprise a receptacle. Theprotrusion may be configured to snap fit into the receptacle to couplethe collar to the illumination element.

The collar may be configured to slide axially over the coupling bracket,at least a portion of the fiber optic input, and at least a portion ofthe illumination element. The collar may be adhesively coupled orotherwise adhered to at least one of the coupling bracket, the fiberoptic input, or the illumination element. Methods for adhesion maycomprise press-fitting, crimping, welding, and other methods known inthe field.

The surgical illumination apparatus may further comprise an articulatedtrack attachment for attaching the fiber optic input to the surgicalinstrument. The articulated track attachment may comprise a proximalend, a distal end, a bottom surface, a top surface, and two sides, andmay further comprise a plurality of rails separated by alternating slotsand aligned to form a flexible track that extends between the proximaland distal ends. The articulated track may be configured to conform toangles of between −180 and 180 degrees, wherein an angle of 0 degreescorresponds to an unflexed flat position. The proximal and distal endsof the articulated track attachment may each comprise a coupling elementconfigured to receive the fiber optic input and to attach to thesurgical instrument. The articulated track attachment may comprise aplurality of protrusions aligned on each side to form a central channeland configured to receive the fiber optic input.

One of the articulated track attachment or the surgical instrument maycomprise a protrusion, and the other of the articulated track attachmentor the surgical instrument may comprise a receptacle. The protrusion maybe configured to snap fit into the receptacle to attach the articulatedtrack attachment to the surgical instrument. The surgical instrument maycomprise a camera, a sensor or a retractor.

In another aspect of the present invention, an optical coupling bracketfor optically coupling an illuminated surgical instrument with a fiberoptic input comprises an elongate frame having a proximal end, a distalend, and a central channel extending therebetween. The central channelis defined by an upper surface, a lower surface, and two side walls, andthe channel is sized to receive and support the optical fibers of thefiber optic input. The central channel may be configured to captureoptical fibers arranged in one or more linear arrays that are verticallystacked atop one another. The bracket may comprise one or two protrudingmembers (also referred to as legs) configured to engage the fiber opticinput, the protruding members disposed on the proximal end of the frameand extending in a direction transverse to the longitudinal axis of theframe. The bracket may further comprise one or more engagement elementsconfigured to engage an illumination element of the illuminated surgicalinstrument, wherein the engagement elements are disposed on the distalend of the frame. The engagement elements may comprise one or more holesconfigured to capture one or more pins, screws, or protrusions of theillumination element. One of the bracket or the illumination element maycomprise a protrusion or a receptacle, and the other of the bracket orthe illumination element may comprise a matching receptacle or matchingprotrusion. The protrusion may be configured to snap fit into thereceptacle to couple the bracket to the illumination element.

In another aspect of the present invention, a method for coupling alight input element such as a fiber optic input to an illuminatedsurgical instrument comprises providing the illuminated surgicalinstrument and an optical coupling bracket, disposing the fiber opticinput in the bracket, coupling the fiber optic input to the illuminatedsurgical instrument, and coupling the bracket to the illuminatedsurgical instrument.

The illuminated surgical instrument may comprise a surgical device andan illumination element coupled thereto, and the bracket may comprise aframe having a proximal end, a distal end, and a central channelextending therebetween, sized to receive and support the one or moreoptical fibers of the fiber optic input, and disposing the fiber opticinput in the bracket may comprise disposing the fiber optic input in thecentral channel. Coupling the fiber optic input to the illuminatedsurgical instrument may comprise coupling the fiber optic input to theillumination element.

The fiber optic input may comprise one or more optical fibers, anddisposing the fiber optic input in the channel may comprise arrangingthe one or more optical fibers of the fiber optic input in one or morelinear arrays that are vertically stacked atop one another. The lineararrays may be staggered relative to one another such that the outersurface of one fiber may fit in a trough created by two adjacent fibersin an adjacent linear array. The optical fibers or the fiber optic inputmay be adhesively or otherwise fixedly coupled to the frame of thebracket by disposing an adhesive in the central channel of the opticalcoupling bracket. The method may further comprise trimming or polishingthe one or more optical fibers disposed in the channel.

The bracket may comprise protruding members configured to engage theoptical input, and the optical fibers may be aligned substantiallyparallel to the protruding members and inserted into the channel. A bandmay be placed around the protruding members and the optical fibersdisposed therebetween, so as to couple the optical fibers and thebracket in a stable configuration.

The illumination element may comprise an optical waveguide having apocket disposed on the proximal end, and coupling the fiber optic inputto the illumination element may comprise inserting the distal end of thefiber optic input into the pocket.

The bracket may further comprise one or more engagement elements, andcoupling the bracket to the illumination element may comprise adhesivelybonding the distal end of the bracket frame to the illumination element,or engaging one or more of the engagement elements of the bracket to theillumination element. The engagement elements may comprise one or moreholes disposed on the distal end of the bracket frame, and they may beengaged to the illumination element via one or more pins, screws, orprotrusions of the illumination element. Coupling the bracket to theillumination element may further comprise snap fitting the bracket tothe illumination element.

The method may further comprise providing a shroud, where theillumination element comprises an optical waveguide and the shroud isdisposed around the optical waveguide. The method also comprisescoupling the optical coupling bracket to the shroud. The bracket and theshroud may be formed from a metal material, and one or more surfaces ofthe distal end of the bracket frame may be welded to one or moreinterior surfaces of the shroud.

The method may further comprise magnetically coupling the shroud to thesurgical device. The shroud may comprise one or more magnets that areintegrated with or coupled to one or more surfaces of the shroud,wherein the magnets may be coupled to a magnetic surface of the surgicaldevice. Alternatively, the shroud may comprise a magnetic material thatcan be coupled to one or more magnets integrated with or coupled to oneor more surfaces of the surgical device.

The illumination element may comprise an optical waveguide having apocket disposed on the proximal end, and coupling the bracket to theillumination element may comprise inserting at least the distal end ofthe coupling bracket into the pocket of the optical waveguide.

One of the coupling bracket or the illumination element may comprise aprotrusion, and the other of the coupling bracket or the illuminationelement may comprise a receptacle. The protrusion may be configured tosnap fit into the receptacle to couple the coupling bracket to theillumination element.

The method may further comprise providing a collar, and disposing thecollar over the illumination element, the coupling bracket, and thefiber optic input. One of the collar or the coupling bracket maycomprise a protrusion, and the other of the collar or the couplingbracket may comprise a receptacle. The method may further comprisesnap-fitting the protrusion into the receptacle to couple the collar tothe coupling bracket. The method may further comprise sliding the collarover at least a portion of the illumination element and the couplingbracket and adhesively coupling the collar to at least one of theillumination element or the coupling bracket. The collar may beadhesively coupled or otherwise adhered to at least one of the couplingbracket, the fiber optic input, or the illumination element. Methods foradhesion may comprise press-fitting, crimping, welding, and othermethods known in the field.

In still another aspect of the present invention, a method for couplingan illumination element to a surgical device, comprises providing anillumination element, providing a surgical device, and coupling theillumination element to the surgical device. One of the illuminationelement or the surgical device may comprise a protrusion and the otherof the illumination element or the surgical device may comprise amatching receptacle. The protrusion may be configured to slide into thereceptacle to couple the illumination element to the surgical device.The illumination element may comprise an optical waveguide, and themethod may further comprise coupling the optical waveguide to thesurgical instrument. The protrusion may have a dovetail shape and thematching receptacle may be a dovetail-shaped groove. The surgicalinstrument may comprise a camera, a sensor or a retractor. Obtaining asurgical device may comprise obtaining a camera, a sensor or aretractor.

In still another exemplary embodiment of the present disclosure, asurgical illumination device for providing light to a surgical field ina patient comprises an illumination element, an optical couplingbracket, and a light input element. The illumination element has aproximal portion and a distal portion. The distal portion comprisesoptical structures for extracting light from the illumination elementand directing the extracted light toward the surgical field. Theproximal portion comprises a first leg and a second leg. The legs extendproximally and are disposed on opposite lateral sides of the proximalportion of the illumination element. The proximal portion furthercomprises a receptacle that is defined by a space disposed between thefirst leg, the second leg, and a proximal-most end of the illuminationelement. The optical coupling bracket has a proximal region, a distalregion, and a central channel disposed therebetween. The distal regionis at least partially disposed in the receptacle, and the couplingbracket is coupled to the illumination element. A distal portion of thelight input element is disposed in the central channel of the couplingbracket, and the light input element is configured to provide light froma light source to the illumination element.

The illumination element may be a non-fiber optic optical waveguide.Light may be transmitted through the optical waveguide by total internalreflection. The optical structures may comprise a plurality of facets ora plurality of stair steps, each stair step having a ramp and a step,and an angle between the ramp and the step. The ramp may be asubstantially flat planar surface, and the step may be a substantiallyflat planar surface. The ramp may be disposed at an angle that promotestotal internal reflection of the light in the optical waveguide, and thestep may be disposed at an angle that promotes extraction of the lightfrom the optical waveguide. The distal-most end of the illuminationelement may comprise optical structures configured for extracting thelight therefrom and directing the light to the surgical field.

The optical waveguide may further comprise a pocket disposed on theproximal portion and the pocket may be configured to receive at leastthe distal region of the coupling bracket.

One of optical waveguide or the surgical instrument may further comprisea protrusion and the other of the waveguide or the surgical instrumentmay comprise a matching receptacle. The protrusion may be configured toslide into the receptacle to couple the waveguide to the instrument. Theprotrusion may have a dovetail shape and the matching receptacle may bea dovetail-shaped groove.

The coupling bracket may comprise a keyway element, and the opticalwaveguide may comprise a keyway element having a shape that cooperateswith the coupling bracket keyway element to ensure proper alignment ofthe coupling bracket with the optical waveguide. The light input elementmay comprise a plurality of optical fibers. The plurality of fibers eachmay have a distal end, and the distal ends may be substantially flushwith one another. The plurality of fibers may form a substantially flatplanar ribbon. A sheath may be disposed over the plurality of fibers.

The coupling bracket may further comprise an engagement element disposedadjacent the distal region, and the illumination element may comprise anengagement element configured to engage with the coupling bracketengagement element.

One of the coupling bracket or the illumination element of the devicemay comprise a protrusion, and the other of the coupling bracket or theillumination element may comprise a receptacle. The protrusion may beconfigured to snap fit into the receptacle to couple the bracket to theillumination element.

The central channel of the coupling bracket may have a substantiallyparallelogram shaped cross-section. The coupling bracket may beadhesively coupled to the illumination element. The coupling bracket maybe releasably coupled to the illumination element. One of the bracket orthe illumination element may further comprise a protrusion, and theother of the bracket or the illumination element may comprise areceptacle. The protrusion may be configured to snap fit into thereceptacle to couple the bracket to the illumination element.

The device may further comprise an instrument that is coupled to theillumination element. The instrument may be a surgical instrument suchas a surgical retractor, a tool, or any other instrument.

The device may further comprise a collar disposed over the couplingbracket, at least a portion of the fiber optic input, and at least aportion of the illumination element. One of the collar or the couplingbracket may comprise a protrusion, and the other of the collar or thecoupling bracket may comprise a receptacle. The protrusion may beconfigured to snap fit into the receptacle to couple the collar to thecoupling bracket. The collar may be configured to slide over at least aportion of the illumination element and the coupling bracket. The collarmay be adhesively coupled or otherwise adhered to at least one of thecoupling bracket, the light input element, or the illumination element.Methods for adhesion may comprise press-fitting, crimping, welding, andother methods known in the field.

The device may further comprise a surgical instrument and an articulatedtrack attachment for attaching the light input element to the surgicalinstrument. The articulated track attachment may comprise a proximalend, a distal end, a bottom surface, a top surface, and two sides. Aplurality of rails separated by alternating slots and aligned to form aflexible track may extend between the proximal and distal ends. Thearticulated track may be configured to conform to angles of between −180and 180 degrees, wherein an angle of 0 degrees corresponds to anunflexed flat position. The proximal and distal ends may each comprise acoupling element configured to receive the light input element and toattach to the surgical instrument.

The articulated track attachment may further comprise a plurality ofprotrusions aligned on each side of the track to form a central channeland configured to receive the light input element. One of thearticulated track attachment or the surgical instrument may comprise aprotrusion, and the other of the articulated track attachment or thesurgical instrument may comprise a receptacle. The protrusion may beconfigured to snap fit into the receptacle to couple the articulatedtrack attachment to the surgical instrument.

In another aspect of the present invention, an articulated trackattachment device for attaching a fiber input element to a surgicalinstrument may comprise a proximal end, a distal end, a bottom surface,a top surface, and two sides. A plurality of rails separated byalternating slots and aligned to form a flexible track may extendbetween the proximal and distal ends of the device. The articulatedtrack may be configured to conform to angles of between −180 and 180degrees, wherein an angle of 0 degrees corresponds to an unflexed flatposition. The proximal and distal ends may each comprise a couplingelement configured to receive the fiber input element and to attach tothe surgical instrument.

The articulated track attachment device may attach a fiber optic inputto a surgical instrument. The articulated track attachment device mayfurther comprise a plurality of protrusions aligned on each side of thedevice to form a central channel and configured to receive the fiberoptic input. One of the articulated track attachment device or thesurgical instrument may comprise a protrusion, and the other of thearticulated track attachment device or the surgical instrument maycomprise a receptacle. The protrusion may be configured to snap fit intothe receptacle to couple the articulated track attachment device to thesurgical instrument. The surgical instrument may comprise a camera, asensor or a retractor.

In yet another aspect of the present invention, a method of attaching afiber input element to a surgical instrument comprises providing a fiberinput element and a surgical instrument, providing an articulated trackattachment device, disposing the fiber input element in the articulatedtrack attachment device, and attaching the articulated track attachmentdevice to the surgical instrument.

The fiber input element may comprise a fiber optic input and attachingthe articulated track attachment device to the surgical instrument maycomprise coupling a proximal end of the device to the surgicalinstrument and coupling a distal end of the device to the surgicalinstrument. One of the articulated track attachment device or thesurgical instrument may comprise a protrusion, and the other of thearticulated track attachment device or the surgical instrument maycomprise a receptacle. Attaching the articulated track attachment deviceto the surgical instrument may comprise snap fitting the protrusion intothe receptacle. The method may further comprise flexing the articulatedtrack attachment device to an angle of between −180 and 180 degrees,wherein an angle of 0 degrees corresponds to an unflexed flat position.The surgical instrument may comprise a camera, a sensor or a retractor.

These and other embodiments are described in further detail in thefollowing description related to the appended figures.

INCORPORATION BY REFERENCE

All publications, patents, and patent applications mentioned in thisspecification are herein incorporated by reference to the same extent asif each individual publication, patent, or patent application wasspecifically and individually indicated to be incorporated by reference.

BRIEF DESCRIPTION OF THE DRAWINGS

The novel features of the invention are set forth with particularity inthe appended claims. A better understanding of the features andadvantages of the present invention will be obtained by reference to thefollowing detailed description that sets forth illustrative embodiments,in which the principles of the invention are utilized, and theaccompanying drawings of which:

FIG. 1 shows a perspective view of an exemplary embodiment of anilluminated surgical apparatus.

FIG. 2 shows a perspective view of an exemplary embodiment of an opticalcoupling bracket.

FIG. 3 shows a perspective view of an exemplary embodiment of an opticalcoupling bracket with captured optical fibers.

FIG. 4 shows a perspective view of an exemplary embodiment of an opticalcoupling bracket coupled to an optical waveguide.

FIG. 5A shows a perspective view of an exemplary embodiment of anoptical coupling bracket coupling optical fibers to an optical waveguidesurrounded by a shroud.

FIG. 5B shows a vertical cross-section of a shroud disposed around anoptical waveguide.

FIG. 6 shows a perspective view of an exemplary embodiment of an opticalcoupling bracket coupling a fiber optic input to an optical waveguidesurrounded by a shroud.

FIG. 7 shows a side view of an exemplary embodiment of magnetic couplingof a shroud disposed around an optical waveguide to a surgical device.

FIG. 8A shows a perspective view of an alternative embodiment of anillumination element.

FIG. 8B shows an end view of FIG. 8A.

FIG. 9A shows a perspective view of an exemplary embodiment of acoupling bracket.

FIG. 9B shows an end view of FIG. 9A.

FIG. 9C shows a top view of FIG. 9A.

FIG. 9D shows a side view of FIG. 9A.

FIG. 10A shows a perspective view of a plurality of optical fibersdisposed in the coupling bracket of FIG. 9A.

FIG. 10B shows a perspective view of FIG. 10A with an outer coverdisposed over the optical fibers.

FIG. 11 shows a perspective view of an exemplary embodiment of anassembly comprising the illumination element of FIG. 8A, the couplingbracket of FIG. 9A, and a light input element which includes opticalfibers in the coupling bracket and an outer cover disposed over theoptical fibers.

FIG. 12A shows a perspective view of an alternative embodiment of anillumination element and a coupling bracket.

FIG. 12B shows engagement of the bracket and illumination elementillustrated in FIG. 12A.

FIG. 12C shows the bracket and illumination element of FIG. 12A coupledtogether.

FIG. 13A shows a perspective view of an alternative embodiment of anillumination element.

FIG. 13B shows an end view of the illumination element from FIG. 13Aengaged with a surgical instrument.

FIG. 14A shows a perspective view of the embodiment of FIG. 12C and acollar.

FIG. 14B shows a bottom perspective view of the embodiment of FIG. 14A.

FIG. 14C shows the collar of FIGS. 14A-14B disposed over theillumination element.

FIG. 15A shows a perspective view of an alternative embodiment of anillumination element, a coupling bracket, a fiber optic input, and acollar.

FIG. 15B shows the embodiment of FIG. 15A with the collar disposed overthe illumination element.

FIGS. 16A-16D show a perspective view, an end view, a top view, and aside view respectively of an embodiment of an articulated trackattachment.

FIGS. 17A-17C show a perspective view, an end view, and a side viewrespectively of an embodiment of an articulated track attachment flexed.

FIG. 18A shows a perspective view of an embodiment of an illuminatedsurgical apparatus comprising a surgical retractor coupled to an opticalwaveguide, a fiber optic input, a coupling bracket, a collar, and anarticulated track attachment device.

FIG. 18B shows a cross-sectional view of the surgical retractor blade ofFIG. 18A taken where the waveguide is coupled to the blade.

DETAILED DESCRIPTION OF THE INVENTION

The method and apparatus as disclosed herein are suited for use with anyillumination element coupled with a light input element such as a fiberoptic input but will be described specifically for use with surgicaldevices, including surgical retractors and suction devices. They areespecially well-suited for low-profile devices to be used in minimallyor less invasive surgeries, where the surgical operations are performedwithin narrow cavities formed from minimal surgical incisions.

An optical waveguide as described herein may transmit light from anillumination input such as a fiber optic input through the waveguide bytotal internal reflection. The light can be extracted from the waveguidevia one or more surface features disposed on one or more surfaces of thewaveguide. The waveguide may also comprise an angled distal tip fordirecting the remaining light that has not been extracted by the surfacefeatures to the surgical field. The light-emitting surfaces of thewaveguide can control the direction of the extracted light, such thatthe light illuminates the surgical field. An exemplary embodiment of theoptical waveguide and its features are described in greater detail inU.S. patent application Ser. Nos. 11/654,874, 11/923,483, and14/035,583, the entire contents of which are incorporated herein byreference. Any of the features described in the above mentionedreferences incorporated herein by reference may be used in combinationwith or as a substitution for any of the features described in thisspecification.

While the illumination element as described herein often comprises anoptical waveguide, one of skill in the art will appreciate that anynumber of illumination elements such as LED lights, incandescent lights,or fiber optics may be used instead of an optical waveguide.

FIG. 1 shows a perspective view of an exemplary embodiment of anilluminated surgical apparatus 10. The illuminated surgical apparatuscomprises a fiber optic input 100, an illuminated surgical instrument200, and an optical coupling bracket 300. The fiber optic inputcomprises one or more optical fibers. The illuminated surgicalinstrument comprises a surgical device 210 and an illumination element220 coupled thereto. The optical coupling bracket receives and supportsthe fiber optic input, and couples the fiber optic input to theillumination element of the illuminated surgical instrument. Theillumination element is configured to emit light 140 from the fiberoptic input toward the surgical field 20. Additionally, the couplingbracket facilitates efficient coupling of the light input into theillumination element thereby reducing light loss and undesired heating.

In some embodiments, the illumination element comprises an opticalwaveguide 225 having one or more light emitting surfaces 230 adapted toface the surgical field. The light emitting surfaces may comprise aplurality of light extraction features such as facets, ridges, steps, orshoulders, or other geometries useful for extracting light from thewaveguide and directing the light to the surgical field. In someembodiments, the illuminated surgical instrument further comprises anoptional shroud 400 disposed around the optical waveguide, so as toprotect the waveguide from damage and to provide additional structuralintegrity to the waveguide.

FIG. 2 shows a perspective view of an exemplary embodiment of an opticalcoupling bracket 300. The bracket comprises an elongate frame 305 havinga proximal end 310, distal end 315, and a central channel 320 extendingtherebetween. The frame may comprise a rigid material, such as a metalor a rigid polymer, that can retain its structural integrity throughoutits manufacturing process or its use in a surgical illuminationapparatus. The central channel is defined by an upper surface 325, lowersurface 330, and two side walls 335, and is sized to receive and supportthe light input element which in this embodiment is preferably one ormore optical fibers of the fiber optic input. The proximal end can becoupled to the fiber optic input, and the distal end can be coupled toan illumination element configured to emit light from the fiber opticinput.

The bracket may further comprise one or more protruding members (alsoreferred to as legs) 340 disposed on the proximal end of the frame,adjacent to both side walls of the central channel, and extending in adirection transverse to the longitudinal axis 30 of the frame. In someembodiments, the protruding members 340 may extend perpendicularly tothe longitudinal axis of the frame and in a proximal direction. Theprotruding members may comprise a rigid material similar to the materialof the frame, and may be configured to flank the sides of the portion ofthe optical input extending past the proximal end of the frame, therebyproviding further structural support to the optical input. Theprotruding members may be integrally formed with the frame or they maybe separate components attached to the frame using methods known in theart.

The bracket may further comprise one or more engagement elements 345disposed on the distal end of the frame, configured to engage theillumination element. The engagement elements may comprise one or moreholes 350 configured to capture one or more of pins, screws, orprotrusions disposed on and extending outward from a proximal surface ofthe illumination element, so as to fixedly or otherwise releasablyengage the bracket to the illumination element.

FIG. 3 shows a perspective view of an exemplary embodiment of an opticalcoupling bracket 300 with captured optical fibers 105. One or moreoptical fibers of the fiber optic input may be inserted into the centralchannel 320, optionally such that the distal tip 120 of the fibersextend past the distal end 315 of the frame 305. The fibers may befixedly disposed in the channel by means of an adhesive 115. The opticalfibers may be arranged in one or more linear arrays 110 that can bevertically stacked atop one another, such that the fibers can have anarrow profile that allows the bracket with the captured fibers to becoupled to a surgical device requiring a narrow profile for use. In someembodiments, the optical fibers are aligned in a configuration parallelto one or more protruding members 340 of the bracket, disposed asdescribed herein. The protruding members may be configured to flank thesides of the portion of the optical fibers extending past the proximalend 310 of the frame, so as to provide additional structural support toprotect the optical fibers against flexural loads and stresses at theproximal end of the frame. The fibers of one linear array may be offsetfrom the fibers of an adjacent linear array such that the outercircumference of one or more fibers fits in a receptacle (also referredto as a trough) formed by adjacent fibers in an adjacent linear array.

The optical coupling bracket may also be used as a manufacturingfixture, providing a means to support optical fibers while the fibersundergo manufacturing processes such as trimming and polishing. Graspingthe optical fibers without any intermediary structure may be difficult,and can subject the fibers to damage during the manufacturing processes.The bracket can facilitate the grasping and support of the fibers, andprovide a structure that can interface with tooling fixtures whilereducing the stresses placed on the fibers.

FIG. 4 shows a perspective view of an exemplary embodiment of an opticalcoupling bracket 300 coupled to an optical waveguide 225. The opticalwaveguide may comprise a pocket 235 disposed on a proximal end 240 ofthe waveguide, which can be sized to receive the optical fibers 105extending past the distal end 315 of the bracket frame 305. The bracketis coupled to the optical waveguide by engaging the distal end of theframe with the proximal end of the waveguide. The waveguide may beadhesively bonded to the distal end of the frame, or coupled to one ormore engagement elements 345 disposed on the distal end of the frame.The engagement elements may comprise holes 350, and the waveguide may becoupled to the frame by means of pins or screws disposed in the holes.Alternately, the waveguide may comprise one or more protrusions disposedon the proximal end, and the protrusions may be disposed in the holes toattach the waveguide to the bracket frame. In alternative embodiments,adhesive may be used to bond the frame with the waveguide. In someembodiments, the frame and fibers may be fixedly attached to thewaveguide, while in other embodiments, they are releasably coupledtogether.

The pocket of the waveguide can receive and support the distal end ofthe optical fibers, keeping the optical fibers together in a stableconfiguration, while providing a large bonding area between the opticalfibers and the waveguide so as to enable the secure attachment of thefibers to the waveguide. The pocket can also provide a means to attachthe fibers to the waveguide without interfering with light extractionfrom the waveguide. The pocket creates one or more dead zones 245 thatlie outside of the light path, disposed between the proximal surface 240of the waveguide and the distal tip 120 of the optical fibers. Since thedead zones lay proximal to the tip of fibers, they do not interfere withthe propagation of light 140 from the fiber optic input, and the lightcan be transmitted past the dead zones to the light-emitting surfaces ofthe waveguide. Thus contact in the dead zones minimizes light loss andis a preferred location for engagement with adjacent components.

Coupling the optical fibers to the waveguide by means of the pocket caneliminate the need for an additional, external mechanical clasp feature,thereby keeping the profile of the waveguide as minimal as possible soas to enable the waveguide to be used in conjunction with a wide varietyof surgical devices requiring a narrow profile. In addition, lightextraction from the waveguide can be optimized without the use of anexternal mechanical clasp, since an external clasp can interfere withlight extraction by potentially covering a portion of the externalsurface of the waveguide disposed in the path of light propagationthereby resulting in light loss in the contact area.

Preferably, the depth 250 of the pocket is about 3 mm or less, so as tomaximize the area of the light-emitting surface of the optical waveguideand thereby optimize control over the light. A deeper pocket may furtherincrease the area of the dead zones, which are outside of the path oflight propagation and hence may not function as light-emitting surfaces.A deeper pocket may also pose additional challenges during themanufacturing of the optical waveguide. The interior surfaces of adeeper pocket may be difficult to polish sufficiently for the optimaltransmission of light, and a deeper pocket may also require a largerdraft angle to be used during the molding of the pocket, resulting in aless than ideal pocket configuration for securely holding the opticalfibers.

In some embodiments, the optical coupling bracket 300 further comprisesprotruding members 340 as described herein, wherein the protrudingmembers provide additional structural support to the optical fibers. Theprotruding members can serve to virtually extend the depth of theoptical waveguide pocket, thereby providing further stability to theattachment of the optical fibers to the waveguide, without increasingthe actual depth 250 of the pocket.

FIG. 5A shows a perspective view of an exemplary embodiment of anoptical coupling bracket 300 coupling optical fibers 105 to an opticalwaveguide 225 surrounded by an optional shroud 400. In some embodiments,the optical waveguide may be surrounded with a shroud in order toprotect the waveguide from damage and to facilitate the handling of thewaveguide. The shroud is disposed around at least a portion of aperimeter of the waveguide, and may comprise a rigid material similar tothe material of the bracket. In some embodiments, both the shroud andthe bracket are formed from a metal material, and the bracket may befixedly coupled to the shroud by welding one or more surfaces of thebracket frame to one or more interior surfaces of the shroud.

FIG. 5B shows a vertical cross-section of a shroud 400 and disposedaround an optical waveguide 225. The cross-section is taken along lineB-B in FIG. 5A. The shroud comprises one or more openings 415 on a topsurface 405, on a bottom surface 410, or on both the top surface and thebottom surface of the shroud. The openings are configured to allow thelight-emitting surfaces 230 of the waveguide to emit light from thefiber optic input toward the surgical field, wherein the light-emittingsurfaces may be disposed on one or more of a top surface, a bottomsurface, or a distal tip of the waveguide. Preferably, the shroud isconfigured to maintain an air gap 420 between the waveguide and one ormore interior surfaces of the shroud, so as to minimize the degree towhich the shroud may interfere with light propagation through thewaveguide because light loss may occur at points of contact with thewaveguide.

FIG. 6 shows a perspective view of an exemplary embodiment of an opticalcoupling bracket 300 coupling an fiber optic input 100 to an opticalwaveguide 225 surrounded by a shroud 400. The fiber optic input,bracket, and waveguide may be coupled together as described herein. Theproximal portion of the fiber optic input, extending past the proximalend 310 of the bracket frame 305, may form a short, structurallyreinforced section referred to as a pigtail 125. The pigtail maycomprise the proximal portion of the optical fibers disposed between theprotruding members 340, as described herein, and optionally a band 130disposed around the protruding members. The band such as a heat shrinkwrap, optical cladding or any other cover, can help to couple theoptical fibers and the bracket in a stable configuration, and reduce theflexural loads and stresses at the proximal connection between theoptical fibers and the bracket. The pigtail can further connect to acable or ribbon 135 that optically couples the pigtail to the lightsource of the fiber optic input.

In some embodiments, the shroud 400 further comprises one or moremagnets 425 configured to magnetically couple the shroud with a surgicaldevice. The magnets may be integrated with or coupled to one or moresurfaces of the shroud. The magnetic coupling of the shroud to thesurgical device can provide additional support to the distal end of theoptical waveguide, so as to prevent the distal end of the waveguide fromflipping up away from the surface of the surgical device. The magnetsare of suitable strength so that the shroud is secured to the surgicaldevice and unwanted movement is prevented during the surgical procedure.Additionally, the magnet strength may be selected to allow easyattachment and detachment of the shroud from the surgical device,thereby allowing repositioning. In some circumstances, the surgicaldevice may not be magnetic, and thus tape strips of ferrous metal orother magnetic materials may be applied to the surgical device so thatthe shroud may be magnetically coupled thereto.

FIG. 7 shows a side view of an exemplary embodiment of the magneticcoupling of a shroud 400 disposed around an optical waveguide 225 to asurgical device 210. One or more small, discrete magnets 425 areintegrated into the shroud, and the magnets couple the shroud and theoptical waveguide disposed within the shroud to a magnetic surface ofthe surgical device. The magnets may be configured to be moveable withinthe shroud, for example up and down the length of the shroud in thedirection of the arrow 430, such that the shroud may be adapted toattach to a curved surface of a surgical device.

Alternately to having magnets coupled to the shroud, the magnets mayalso be integrated with or coupled to one or more surfaces of thesurgical device, such that a shroud comprising a magnetic material maybe magnetically coupled thereto.

The various features disclosed herein may be mixed, matched, orsubstituted with one another. Thus, for example, any of optical couplingbracket embodiments may be combined with any additional structuralfeature disclosed herein, such as the shroud. Any of the featuresdisclosed in this application may also be used in conjunction with orsubstituted with any of the features disclosed in the patents andapplications incorporated herein by reference.

FIGS. 8A-8B show an alternative embodiment of an illumination element802. The illumination element 802 has a distal portion 806 and aproximal portion 804. A plurality of optical structures 808 are disposedalong the distal portion of the illumination element and they are shapedto help efficiently transmit light from the proximal portion to thedistal portion of the illumination element. The plurality of opticalstructures 808 are also shaped to facilitate extraction of light fromthe illumination element and to direct the extracted light toward atarget work area such as a surgical field. The proximal portion includestwo legs 810 on either lateral side of the illumination element. Aproximal-most end 816 of the illumination element and the two legs 810define a pocket or receptacle 814 that is sized to receive anillumination element as described below. A keyway element 812 which inthis embodiment may be a channel extending along the longitudinal axisof one or both legs is sized to receive a correspondingly shaped keywayelement on a light input element or a coupling bracket to ensure properalignment and orientation of the illumination element with the inputelement or coupling bracket as will be discussed in greater detailbelow. The illumination element is preferably a non-fiber optic opticalwaveguide and the light is preferably transmitted therethrough via totalinternal reflection. The optical structures may be any optical structuredisclosed in this specification or in any of the references incorporatedby reference, or otherwise known in the art, and may include opticalstructures such as lenses, facets, prisms, etc. In preferred embodimentsthe optical structures are stair steps having a ramp surface and a stepsurface. The ramp is preferably angled to promote total internalreflection of light within the optical waveguide, and the step ispreferably angled to extract the light from the illumination element anddirect the extracted light to the target work area such as a surgicalfield. An angle may be disposed between the ramp and step surfaces. Thisangle may be constant along the optical structures, or this angle maychange from stair step to stair step. The distal-most face or surface ofthe illumination element may also have optical structures for extractingand controlling the light as will be described in greater detail below.The legs 810 provide dead zones where light does not pass orsubstantially no light passes, therefore the legs form ideal locationsfor engagement with the light input or coupling bracket, therebyminimizing light loss due to contact between the input and theillumination element. FIG. 8B illustrates an end view of theillumination element, highlighting the proximal end thereof. The keywayelements in this exemplary embodiment are D-shaped channels extendingthrough both legs, although one of skill in the art will appreciate thatmany other shapes are possible and this is not intended to be limiting.

FIGS. 9A-9D show an exemplary coupling bracket 902 that may be fittedwith the illumination element in FIGS. 8A-8B above and helps couple alight input element with the illumination element. The coupling bracket902 has a proximal portion 904 and a distal portion 906. A centralchannel 908 extends through the bracket from the proximal portion to thedistal portion. A keyway element 910 is disposed on one or both lateralsides of the coupling bracket and has a shape that corresponds with thekeyway element 812 on the illumination element 802 so that the twokeyway elements slidably engage one another and ensure proper alignmentand orientation of the illumination element 802 with the couplingbracket 902. In this exemplary embodiment, the keyway element 910 ispreferably a protrusion on both sides of the coupling bracket and theprotrusion has a D-shaped cross-section sized to fit into the D-shapedchannel 812 on the illumination element. Additionally, wings 912 mayalso be provided on one or both lateral sides of the coupling bracket toprovide additional surfaces that help align and engage the couplingbracket with the illumination element when the coupling bracket isreceived in the receptacle in the illumination element. Additionalalignment elements such as rectangular tabs 914, 920 may extend outwardfrom the wings 912 to also provide alignment and engagement surfaces formating with the illumination element, or an instrument such as aretractor or other surgical instrument which may be coupled with theillumination element. Tab 914 is preferably an elongate rectangularshaped protrusion having a longitudinal axis which is generally parallelwith the longitudinal axis of the coupling bracket or the centralchannel. Coupling bracket is also a preferably an elongate rectangularshaped protrusion but it is oriented transversely relative to tab 914such that the longitudinal axis of tab 920 is transverse or orthogonalto the longitudinal axis of the coupling bracket or central channel. Adistal face 916 of either wing 912 is preferably a flat planar surfaceto allow the coupling bracket to butt firmly and evenly against theillumination element. Similarly, the distal-most face 918 of thecoupling bracket is also preferably a flat planar surface to furtherfacilitate firm and even engagement of the coupling bracket against asurface of the illumination element when disposed therein. The proximalportion of the coupling bracket may be any shape, but in this embodimenthas a slightly proximally facing taper to ensure a smooth transitionwith the illumination element when the illumination element is coupledtherewith. The distal portion of the coupling bracket may also be anyshape, but in this exemplary embodiment is preferably rectangularshaped. The central channel 908 is preferably parallelogram shaped withparallel upper and lower walls, and inwardly canted side walls.

FIG. 9B shows an end view of the coupling bracket and highlights thecentral channel 908. The central channel is sized to receive a lightinput element which in preferred embodiments is one or more fiberoptics. When the light input element includes a plurality of fiberoptics, the individual optical fibers may be aligned and stacked as oneor more linear arrays of fibers stacked on top of one another as will beillustrated later. FIG. 9C illustrates a top view of the couplingbracket 902 and FIG. 9D shows a side view of the coupling bracket 902.

FIG. 10A shows a perspective view of the coupling bracket 902 describedabove with a light input element 1006 disposed in the central channel908. In this embodiment, the light input element comprises a pluralityof optical fibers that are arranged in two rows of fibers stacked on topof one another. The fibers 1002 are aligned in two linear arrays withthe two arrays slightly staggered or offset from one another so that thebottom portion of an upper fiber fits in a trough formed by two adjacentfibers on the bottom. Similarly, a top portion of a lower fiber fits inthe trough formed by two adjacent fibers on a top row. This helpsmaximize fiber packing and minimizes profile. Each fiber in a lineararray is adjacent another fiber so that their outer circumferencesengage one another. Additionally, the distal-most faces 1004 of thefibers are preferably aligned with the distal-most end of the couplingbracket forming a smooth, flat and flush distal end that can be buttedagainst the illumination element when the assembly of the couplingbracket and optical fibers are disposed in the receptacle. Just aspreviously disclosed, the coupling bracket may also be used duringmanufacturing as a process aid to help fixture the fibers so that theycan be polished and otherwise processed.

FIG. 10B shows an alternative embodiment of FIG. 10A, where an outercover or sheath 1008 may be disposed over the light input element 1006which includes optical fibers 1002. The sheath may be heat shrink, anoptical cladding, or another other cover to help protect the fibers, orto provide desired optical properties to the fiber bundle, or the helpkeep the fibers shaped into a ribbon.

FIG. 11 shows an exemplary embodiment of an assembly comprising theillumination element 802 with the coupling bracket 902 and the lightinput element 1006 covered by the outer cover 1008. The assembly maythen be fixedly or removably coupled to a tool or instrument such as asurgical retractor blade to help illuminate a surgical field. Anyinstrument may be coupled to the assembly in order to illuminate thework area. Preferred embodiments utilize a surgical instrument ormedical device such as a suction tube, an electrosurgical instrument, acamera, a sensor, or any other instrument or tool. In the assembly ofFIG. 11, the assembly may be coupled together fixedly or releasably. Forexample, adhesive may be used to bond the assembly together. Theadhesive may be an optical adhesive having desired index matchingproperties to ensure efficient transmission of light from the lightinput element to the illumination element. In other embodiments, theassembly may be snap fit together, snap fit or threadably engaged withone another, or any other coupling means may be used to join thecomponents together. FIG. 11 also highlights the distal-most end of theillumination element which may have optical structures for extractingand directing light to the work area such as a surgical field. Otheraspects such as a shroud, magnetic coupling, or any other featurespreviously described may be combined with or substituted for features ofthe present embodiment.

FIGS. 12A-12C show a perspective view of an alternative embodiment of anillumination element 1300 and a coupling bracket 1200. The illuminationelement may comprise an optical waveguide 1300 having a distal end 1310and a proximal end 1320. The optical waveguide 1300 may further comprisea pocket 1330 disposed on the proximal end 1320 and the pocket 1330 maybe configured to receive at least the distal end 1210 of the couplingbracket 1200. The coupling bracket 1200 may further comprise aprotrusion 1205 and/or a receptacle 1215, and the waveguide 1300 maycomprise a matching receptacle 1305 and/or matching protrusion 1315. Theprotrusions 1205 and 1315 may be configured to snap fit into thereceptacles 1305 and 1215 to couple the bracket to the illuminationelement. The waveguide 1300 may further comprise a protrusion 1325 thatextends partially or completely as shown on the sides of the waveguide,configured to slide into a matching receptacle on a surgical instrument(not shown). FIG. 12B shows how the bracket 1200 may be insertedvertically into the pocket 1330 of the waveguide 1300. FIG. 12C showshow the bracket may be disposed in the pocket 1330 of the waveguide 1300and also shows how the bracket may be coupled to the waveguide 1300 bysnap fitting the protrusions 1205 and 1315 into the receptacles 1305 and1215.

Coupling the bracket to the waveguide by means of the pocket caneliminate the need for an additional, external mechanical clasp feature,thereby keeping the profile of the waveguide as minimal as possible soas to enable the waveguide to be used in conjunction with a wide varietyof surgical devices requiring a narrow profile. In addition, lightextraction from the waveguide can be optimized without the use of anexternal mechanical clasp, since an external clasp can interfere withlight extraction by potentially covering a portion of the externalsurface of the waveguide disposed in the path of light propagationthereby resulting in light loss in the contact area.

FIG. 13A shows a perspective view of an alternative embodiment of anillumination element 1300 that may be used with any of the embodimentsdescribed herein. The illumination element may comprise an opticalwaveguide 1300 that may comprise a protrusion 1325 configured to slideinto a matching receptacle on a surgical instrument (not shown). Theoptical waveguide 1300 or the surgical instrument may comprise aprotrusion and the other of the waveguide or the surgical instrument maycomprise a matching receptacle. The protrusion may be configured toslide into the receptacle to couple the waveguide to the instrument. Theprotrusion may be any shape such as a dovetail or other shape and it mayextend partially or completely along one or both sides of the waveguide.

FIG. 13B shows an end view of the embodiment of FIG. 13A. The protrusion1325 on the waveguide 1300 may be slid into a matching receptacle 1335on a surgical instrument 1345 such as a retractor blade, or any othersurgical instrument described herein. FIG. 13B further shows that theprotrusion 1325 may have a dovetail-shape and the matching receptacle1335 may be a dovetail-shaped groove.

FIG. 14A shows a perspective view of the embodiment of FIG. 12C and acollar 1400 configured to be disposed over at least a portion of theillumination element 300, at least a portion of the fiber optic input(not shown), and the coupling bracket 1200. The illumination element maycomprise an optical waveguide 1300. One of the collar 1400 or thecoupling bracket 1200 may comprise a protrusion, and the other of thecollar or the coupling bracket may comprise a receptacle. The protrusionmay be configured to snap fit into the receptacle to couple the collar1400 to the coupling bracket 1200. The collar may comprise arectangular, square or other geometrically shaped tube. The tube maydefine a central channel sized to receive, protect, support, or securethe coupling interface between any of the illumination element 300, thecoupling bracket 1200, and the fiber optic input. The collar may alsoprovide strain relief for the various components of the apparatus ordevice.

FIG. 14B shows an alternative perspective view of the embodiment of FIG.12C and the collar 1400 of FIG. 14A. The collar 1400 may comprise areceptacle 1415 and the coupling bracket 1200 may comprise a protrusion1235. The protrusion 1235 may be configured to snap fit into thereceptacle 1415 to couple the collar 1400 to the coupling bracket 1200as the collar 1400 is moved axially over the coupling bracket 1200.

FIG. 14C shows the collar 1400 of FIG. 14B disposed over at least aportion of the embodiment of FIG. 12C. The coupling bracket 1200 maycomprise a protrusion 1235, which may be snap fit into a receptacle 1415on the collar 1400 to couple the collar 1400 to the coupling bracket1200 as shown in FIG. 14C.

FIG. 15A shows a perspective view of an alternative embodiment of anillumination element 1300, a coupling bracket 1200, light input element1506, and a collar 1500, configured to be disposed over the illuminationelement 1300, the coupling bracket 1200, and the light input element1506. The illumination element may preferably comprise an opticalwaveguide 1300, and the light input element may preferably comprise afiber optic input 1506. The collar 1500 may be configured to slide overat least a portion of the optical waveguide 1300 and the couplingbracket 1200. The collar 1500 may be adhesively coupled or otherwiseadhered to at least one of the coupling bracket 1200, the fiber opticinput 1506, or the optical waveguide 1300. Methods for adhesion maycomprise press-fitting, crimping, welding, and other methods known inthe field. At least a portion of the fiber optic input 1506 may bedisposed in a cover 1508.

FIG. 15B shows the embodiment of FIG. 15A and further shows how thecollar 1500 may be disposed over at least a portion of the waveguide1300 and the coupling bracket 1200. The collar may comprise arectangular, square or other geometrically shaped tube. The tube maydefine a central channel sized to receive, protect, support, or securethe coupling interface between any of the illumination element 300, thecoupling bracket 1200, and the fiber optic input 1506. The collar mayalso provide strain relief for the various components of the apparatusor device.

FIG. 16A shows a perspective view of an embodiment of an articulatedtrack attachment for attaching a fiber optic input to a surgicalinstrument. The articulated track attachment 1600 may comprise aproximal end 1620, a distal end 1610, and two sides 1601 and 1602. Thearticulated track attachment may further comprise a plurality of rails1626 separated by alternating slots 1625 and aligned to form a flexibletrack 1605 that extends between the proximal end 1620 and distal end1610. The proximal end 1620 may comprise a coupling element 1640. Thedistal end 1610 may comprise a coupling element 1630. The couplingelements 1640 and 1630 may be configured to receive the fiber opticinput (not shown) and to attach to the surgical instrument (not shown).The surgical instrument may comprise one or more receptacles (not shown)and the coupling elements may comprise one or more protrusions 1645,1650, and 1660 for snap-fitting into the receptacles to attach thearticulated track attachment 1600 to the surgical instrument. Thearticulated track attachment 1600 may further comprise a plurality ofprotrusions 1615 aligned on each of the two sides 1601 and 1602 to forma central channel 1603 and configured to receive the fiber optic input(not shown). The central channel 1603 may be configured to contain andguide the fiber optic input. The articulated track may be configured toconform to angles of between −180 and 180 degrees, wherein an angle of 0degrees corresponds to an unflexed flat position. By enabling the fiberoptic input to substantially conform to the shape of the surgicalinstrument, the articulated track attachment device may be used tofacilitate the coupling and mating of the fiber optic input with thesurgical instrument in a low-profile configuration and may also be usedto support the fiber optic input and prevent it from kinking. Thesurgical instrument may comprise a camera, a sensor or a retractor.

FIGS. 16B-16D show an end view, top view, and side view respectively ofthe articulated track attachment of FIG. 16A. The articulated trackattachment 1600 in FIGS. 16A-16D is shown substantially unflexed at anangle of about 0 degrees.

FIGS. 17A-17C show a perspective view, an end view, and a side viewrespectively of an embodiment of an articulated track attachment shownflexed to conform to an angle of about 90 degrees.

FIG. 18A shows a perspective view of an embodiment of an illuminatedsurgical apparatus comprising a surgical retractor 1800 coupled to anoptical waveguide 1300, a fiber optic input 1850, a coupling bracket(not visible), a collar 1700, and an articulated track attachment device1600. The surgical retractor may comprise a blade 1825 on its distal end1810 and a handle 1815 on its proximal end 1820. The surgical retractorblade 1825 may comprise a central channel 1830 for containing the fiberoptic input 1850, which may be coupled to the optical waveguide 1300 bythe coupling bracket 1200. The coupling bracket may be protected by thecollar 1700, which may be disposed over at least a portion of thewaveguide 1300, the coupling bracket 1200, and the fiber optic input1850. The articulated track attachment device 1600 may be flexed toconform to about a 90 degree angle for supporting the fiber optic input1850, prevent it from kinking, and to conform to the shape of thesurgical retractor 1800. The articulated track attachment device thusfacilitates coupling and mating of the fiber optic input 1850 with thesurgical retractor 1800 in a low-profile configuration.

FIG. 18B shows a cross-sectional view of the surgical retractor blade ofFIG. 18A taken along line A-A′ in FIG. 18A where the waveguide 1300 iscoupled to the blade 1825. The waveguide 1300 may comprise a protrusion1325 configured to slide into a receptacle 1335 in the central channel1830 of the blade.

While preferred embodiments of the present invention have been shown anddescribed herein, it will be obvious to those skilled in the art thatsuch embodiments are provided by way of example only. Numerousvariations, changes, and substitutions will now occur to those skilledin the art without departing from the invention. It should be understoodthat various alternatives to the embodiments of the invention describedherein may be employed in practicing the invention. It is intended thatthe following claims define the scope of the invention and that methodsand structures within the scope of these claims and their equivalents becovered thereby.

1. (canceled)
 2. A surgical illumination apparatus for illuminating asurgical field in a patient, the surgical illumination apparatuscomprising: a fiber optic input comprising one or more optical fibers;an illumination element coupled with the fiber optic input andconfigured to emit light from the fiber optic input toward a surgicalfield; and an optical coupling bracket for coupling the fiber opticinput to the illumination element, wherein the optical coupling bracketcomprises a frame having a proximal end, a distal end, and a centralchannel extending between the proximal end and the distal end, whereinthe central channel is defined by an upper surface, a lower surface, andtwo side walls, wherein the central channel is sized to receive andsupport the one or more optical fibers in the optical coupling bracket,and wherein the distal end of the optical coupling bracket is coupled tothe illumination element; and a collar disposed over the illuminationelement, the optical coupling bracket, and the fiber optic input.
 3. Thesurgical illumination apparatus of claim 2, wherein the collar isconfigured to slide axially over the optical coupling bracket, at leasta portion of the fiber optic input, and at least a portion of theillumination element.
 4. The surgical illumination apparatus of claim 2,wherein the collar is adhesively coupled to at least one of the opticalcoupling bracket, the fiber optic input, or the illumination element. 5.The surgical illumination apparatus of claim 2, wherein the collar orthe optical coupling bracket comprises a protrusion, and wherein theother of the collar or the optical coupling bracket comprises areceptacle, and wherein the protrusion snap fits into the receptacle. 6.The surgical illumination apparatus of claim 5, wherein the collarcomprises the receptacle and the optical coupling bracket comprises theprotrusion that snap fits into the receptacle.
 7. The surgicalillumination apparatus of claim 2, wherein illumination elementcomprises an optical waveguide.
 8. The surgical illumination apparatusof claim 7, wherein a proximal end of the optical waveguide comprises apocket, wherein the pocket receives the distal end of the opticalcoupling bracket.
 9. The surgical illumination apparatus of claim 8,wherein the distal end of the optical coupling bracket is configured toslide into the pocket in a vertical direction that is parallel to adirection from the upper surface toward the lower surface.
 10. Thesurgical illumination apparatus of claim 8, wherein the optical couplingbracket comprises one or more first protrusions and one or more firstreceptacles, wherein the optical waveguide comprises one or more secondprotrusions and one or more second receptacles in the pocket, andwherein the one or more first protrusions of the optical couplingbracket are received in the one or more second receptacles of theoptical waveguide, and the one or more second protrusions of the opticalwaveguide are received in the one or more first receptacles of theoptical coupling bracket when the optical coupling bracket is positionedin the pocket of the optical waveguide.
 11. The surgical illuminationapparatus of claim 2, wherein the collar is a rectangular shaped tube.12. A method for coupling a fiber optic input to an illuminationelement, comprising: providing a fiber optic input comprising one ormore optical fibers; providing an illumination element configured toemit light from the fiber optic input toward a surgical field; providingan optical coupling bracket for coupling the fiber optic input to theillumination element, wherein the optical coupling bracket comprises aframe having a proximal end, a distal end, and a central channelextending between the proximal end and the distal end, wherein thecentral channel is defined by an upper surface, a lower surface, and twoside walls, wherein the central channel is sized to receive and supportthe one or more optical fibers in the optical coupling bracket,inserting the one or more optical fibers through the proximal end andinto the central channel of the optical coupling bracket; coupling thedistal end of the optical coupling bracket to the illumination element;and disposing a collar over the illumination element, the opticalcoupling bracket, and the fiber optic input.
 13. The method of claim 12,wherein disposing the collar over the illumination element, the opticalcoupling bracket, and the fiber optic input comprises sliding axiallythe collar over the optical coupling bracket, at least a portion of thefiber optic input, and at least a portion of the illumination element.14. The method of claim 12, further comprising adhesively coupling thecollar to at least one of the optical coupling bracket, the fiber opticinput, or the illumination element.
 15. The method of claim 12, whereinone of the collar or the optical coupling bracket comprises aprotrusion, and wherein the other of the collar or the optical couplingbracket comprises a receptacle, and wherein the protrusion snap fitsinto the receptacle.
 16. The method of claim 15, wherein the collarcomprises the receptacle and the optical coupling bracket comprises theprotrusion that snap fits into the receptacle.
 17. The method of claim12, wherein illumination element comprises an optical waveguide.
 18. Themethod of claim 17, wherein a proximal end of the optical waveguidecomprises a pocket, wherein coupling the distal end of the opticalcoupling bracket to the illumination element comprises inserting thedistal end of the optical coupling bracket into the pocket of theoptical waveguide.
 19. The method of claim 18, wherein coupling thedistal end of the optical coupling bracket to the illumination elementcomprises sliding the distal end of the optical coupling bracket intothe pocket in a vertical direction that is parallel to a direction fromthe upper surface toward the lower surface.
 20. The method of claim 18,wherein the optical coupling bracket comprises one or more firstprotrusions and one or more first receptacles, wherein the opticalwaveguide comprises one or more second protrusions and one or moresecond receptacles in the pocket, and wherein the one or more firstprotrusions of the optical coupling bracket are received in the one ormore second receptacles of the optical waveguide, and the one or moresecond protrusions of the optical waveguide are received in the one ormore first receptacles of the optical coupling bracket when the opticalcoupling bracket is positioned in the pocket of the optical waveguide.21. The method of claim 12, wherein inserting the one or more opticalfibers through the proximal end and into the central channel of theoptical coupling bracket comprises arranging the one or more opticalfibers in two linear arrays that are vertically stacked atop oneanother.